C-reactive protein: a new predictor of adverse outcome in pulmonary arterial hypertension.

Objectives Our aim was to investigate in a prospective study a potential role of C-reactive protein (CRP) in predicting the outcome in pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). Background CRP is a well-known marker of inflammation and tissue damage, widely recognized as a risk predictor of cardiovascular and coronary heart diseases. Methods Plasma levels of CRP have been measured in consecutive patients diagnosed with PAH and CTEPH, at the time of right heart catheterization. Results Circulating CRP levels were increased in CTEPH and PAH patients compared with those in control subjects (4.9 mg·l −1 , 95% confidence interval [CI]: 3.9 to 6.2 mg·l −1 ; 4.4 mg·l −1 , 95% CI: 3.5 to 5.4 mg·l −1 ; and 2.3 mg·l −1 , 95% CI: 1.9 to 2.7 mg·l −1 , respectively; p 5.0 mg·l −1 had a significantly lower survival rate (p = 0.02, p = 0.009, and p −1 , 95% CI: 2.8 to 5.8 mg·l −1 , to 1.6 mg·l −1 , 95% CI: 2.2 to 3.0 mg·l −1 ; p = 0.004). PAH patients normalizing their CRP levels under treatment (n = 29), assigned as responders, had a significantly higher survival rate (p Conclusions This is the first evidence of a role of an inflammatory marker, such as CRP, in predicting outcome and response to therapy in PAH.